Expats could soon see access to the NHS based on their National Insurance
contributions, not their country of residence.

Britions who live overseas for more than three months of the year currently lose their right to free health care at home, unless they have a medical emergency during a visit.

However, the government recently carried out a huge consultation into the NHS, suggesting that access to free treatment should be given to those who have made a fair contribution.

A fair contribution would constitute at least seven years of National Insurance contributions, under the proposals.

The current qualifying test for free treatment is whether a person is ordinarily resident. This is deemed to be unfair, as it is satisfied almost immediately by many new and temporary migrants, who may have contributed nothing.

This has angered many expats who have paid National Insurance (NI) all their lives before moving abroad, only to discover they have no access to NHS services for free.

The government’s decision to base NHS eligibility on NI contributions could be a lifeline for those who want to retire abroad, but are prevented from doing so because they cannot afford private medical care overseas.

Leonard Walsh, a British pensioner living in Australia, said: “It’s about time the government did something for us. All the news about expats seems to be negative, with the failure to act over frozen pensions and taking away of winter fuel allowances for some expats. For those of us who paid National Insurance all our lives it is only fair we get to benefit from a free NHS."

Expats of state pension age who have lived in the UK for a continuous period of 10 years remain entitled to some cover even if they permanently live abroad. Expats living within the European Economic Area are also entitled to subsidised health care.

The government’s consultation paper, which can be viewed here, is aimed at clamping down on health tourists who arrive in the UK just for free care.

It includes plans to make temporary residents from outside of the European Economic Area contribute to the cost of their health care with a levy. It also moots the idea of ending free access to primary care for tourists.

The consultation period has now ended, and implementation of the outcome is expected in 2014.